A cohort state-transition model simulated Massachusetts residential centres offering medications for opioid use disorder (OUD), or MOUD. Offering MOUD in all centres raised MOUD time by 36% and prevented 5 overdose deaths per 10,000 at one year. Adding outpatient linkage for all discharged patients was the preferred strategy, at $40,195 per QALY gained. Statewide, it prevented 2.64 overdose deaths per 10,000 people with OUD over 10 years, a 0.40% reduction. Providing MOUD in residential treatment had a five-year budget impact of $9.65 million. The results are modelled, and some centres might close rather than offer MOUD.
Why it is interesting: The model costs a medication that only a small fraction of residential centres currently offer. Per-person gains are small, yet linking all discharges to outpatient care cost less than offering MOUD alone.
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